Richard Wilkinson Emeritus Professor of Social Epidemiologyjcfj.ie/images/plenary/Richard...

Photo by kind permission of Matt Stuart

Inequality: the enemy between us?

Richard Wilkinson

Emeritus Professor of Social Epidemiology

4

Income per head and life-expectancy: rich & poor countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

www.equalitytrust.org.uk Wilkinson & Pickett, The Spirit Level

Life expectancy in rich countries is

no longer related to National Income per head

70

71

72

73

74

75

76

77

78

79

80

Local Neighbourhoods

(in England & Wales)

Life

exp

ecta

ncy (

ye

ars

)

Richest Poorest

Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk

Life expectancy is strongly related to

income within rich countries

3.7 3.94.3

4.6 4.85.2 5.3

5.6 5.6 5.6 5.76.1 6.2

6.7 6.8 6.87.2

8.5

9.7

4.0

8.0

7.0

3.4

Japan

Fin

land

No

rway

Sw

eden

Denm

ark

Belg

ium

Au

str

iaG

erm

an

yN

eth

erl

ands

Sp

ain

Fra

nce

Canada

Sw

izte

rland

Irela

nd

Gre

ece

Italy

Isra

el

New

Zeala

nd

Au

str

alia

UK

Po

rtugal

US

AS

ingap

ore

Income gaps

How many times richer

are the richest fifth than

the poorest fifth?


Inequality...

How much richer are the richest 20% in

each country than the poorest 20%?

Health and social problems with social gradients

and internationally comparable data

• Life expectancy

• Math & Literacy

• Infant mortality

• Homicides

• Imprisonment

• Teenage births

• Trust

• Obesity

• Mental illness – incl. drug &

alcohol addiction

• Social mobility

Wilkinson & Pickett, The Spirit Level

Index of:

• Life expectancy

• Math & Literacy


• Homicides

• Imprisonment

• Teenage births

• Trust

• Obesity

• Mental illness

– incl. drug &

alcohol

addiction

• Social mobility

www.equalitytrust.org.uk

Health and social problems are worse

in more unequal countries

Ind

ex o

f h

ealt

h a

nd

so

cia

l p

rob

lem

s


Neither health nor social problems are

related to national income per head

Index of:

• Life expectancy

• Math & Literacy


• Homicides

• Imprisonment

• Teenage births

• Trust

• Obesity

• Mental illness

– incl. drug &

alcohol

addiction

• Social mobility Ind

ex o

f h

ealt

h a

nd

so

cia

l p

rob

lem

s


Child well-being is better in more equal countries


Child Wellbeing is not related to National Income per head


People in more unequal countries

trust each other less


People in more unequal states of

the USA trust each other less


Mental illness is more common in

more unequal societies

16

Infant Mortality Rates are Higher in More Unequal Countries


0

30

60

90

120

150

180

Income Inequality

Ho

mic

ide

s p

er

millio

n p

eo

ple

Low High

Daly M, Wilson M, Vasdev S. Income inequality and homicide rates in Canada and the United States. Can J Crim 2001; 43: 219-36.

Homicide rates are higher in more unequal

US states and Canadian provinces

USA states

Canadian provinces

18

Teenage Birth Rates are Higher in More Unequal Rich Countries



Social mobility is lower in more unequal countries


Imprisonment rates are higher in

more unequal countries

Imprisonment Rates are Higher in More Unequal US States

Death Penalty: Red = retained Blue = abolished


The age of criminal responsibility is lower in

more unequal societies

Elgar FJ, Craig W, Boyce W, Morgan A, Vella-Zarb R. Income Inequality and School Bullying:

Multilevel Study of Adolescents in 37 Countries. J. Adolescent Health 2009; 45(4): 351-359 .

Income inequality & bullying in 37 countries

Income differences increase social class differentiation

Bigger income differences:-

• Class becomes more important • The social pyramid is higher

and more hierarchical • The quality of social relations

deteriorates

More

inequality

• More superiority and inferiority

• More status competition and consumerism

• More status insecurity

• More worry about

how we are seen and judged

• More “social evaluation anxiety”

(threats to self-esteem & social

status, fear of negative

judgements

Valued or

Devalued?

0

0.2

0.4

0.6

0.8

1

Other

tasks

Tasks with ‘social

evaluative threat’

(uncontrollable)

Co

rtis

ol re

sp

on

se (

eff

ect

siz

e)

Dickerson SS, Kemeny ME. Acute stressors and cortisol

responses. Psychological Bulletin 2004; 130(3): 355-91.

What kind of stressful tasks raise

stress hormones most?

Gilligan J. Violence: Our Deadly Epidemic and its Causes. (G .P. Putnam 1996)

" ...the prison inmates I work with have told me repeatedly,

when I asked them why they had assaulted someone, that it

was because 'he disrespected me', or 'he disrespected my

visit' (meaning 'visitor'). The word 'disrespect' is central in the

vocabulary, moral value system, and psychodynamics of

these chronically violent men that they have abbreviated it

into the slang term, 'he dis'ed me." p.106

A few pages further on Gilligan continues:-

"I have yet to see a serious act of violence that was not

provoked by the experience of feeling shamed and humiliated,

disrespected and ridiculed, and that did not represent the

attempt to prevent or undo this "loss of face " - no matter how

severe the punishment, even if it includes death." p.110

Loughnan S, et al. Economic Inequality is linked to biased self-perception. Psychological Science, 2011; 22: 1254

In more unequal countries people abandon modesty and exaggerate their merits

Wilkinson & Pickett, The Spirit Level

Index of:

• Life expectancy

• Math & Literacy


• Homicides

• Imprisonment

• Teenage births

• Trust

• Obesity

• Mental illness

– incl. drug &

alcohol

addiction

• Social mobility

www.equalitytrust.org.uk

Health and social problems are worse

in more unequal countries

Ind

ex o

f h

ealt

h a

nd

so

cia

l p

rob

lem

s

0

5

10

15

Single

mothers

Low HighFather's occupational class

Infa

nt

death

s p

er

1000 England & Wales

Sweden

Leon, D. A., D. Vagero, et al. (1992). "Social class differences in infant mortality

in Sweden: comparison with England and Wales." Brit Med J 305(6855): 687-91.

The benefits of greater equality are not confined

to the poor but extend to all social classes

Infant mortality by class: Sweden compared with England & Wales

32

Literacy Scores of 16-25 year olds by

Parents' Education

-1.5

-1

-0.5

0

0.5

1

2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Parents' Education (years)

Lit

era

cy s

co

re

Sweden

Canada

United States

Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.

What can be done?

Taxes & benefits

• Stop tax

avoidance

• End tax havens

• Make taxation

progressive

again

Income differences

before tax

• Stronger Trade

Unions

• Increase company

democracy -

employee

ownership etc

• Promote more

directors from

within companies

Sustainability needs

greater equality

Photo by kind permission of Matt Stuart

36

http://www.equalitytrust.org.uk

For more information:

… a book

and a

website…

Richard Wilkinson Emeritus Professor of Social Epidemiologyjcfj.ie/images/plenary/Richard...

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